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Hutchinson's sign: a reappraisal
1Nail Disease Center, Cannes, France.
Journal of the American Academy of Dermatology
|January 1, 1996
Summary
Hutchinson's sign can indicate subungual melanoma but is not always reliable. Pseudo-Hutchinson's sign, mimicking the sign, can lead to misdiagnosis of melanoma.
Area of Science:
- Dermatology
- Oncology
- Nail Medicine
Background:
- Hutchinson's sign, a periungual pigmentation, is a key indicator for subungual melanoma.
- However, this sign is not infallible and can be mimicked by benign conditions.
Purpose of the Study:
- To differentiate true Hutchinson's sign from its mimics.
- To prevent overdiagnosis or underdiagnosis of subungual melanoma.
Main Methods:
- Review of clinical presentations of Hutchinson's sign and its differentials.
- Analysis of cases involving periungual hyperpigmentation.
- Histological confirmation of diagnoses.
Main Results:
- Periungual pigmentation can occur in benign disorders and non-melanoma skin cancers like Bowen's disease.
- Pigmentation of the nail bed/matrix can simulate Hutchinson's sign ('Pseudo-Hutchinson's sign').
- Over-reliance on periungual pigmentation can lead to diagnostic errors.
Conclusions:
- Hutchinson's sign requires careful clinical evaluation alongside other patient data.
- Pseudo-Hutchinson's sign encompasses misleading clues that mimic subungual melanoma.
- Histological examination remains the definitive method for diagnosing subungual melanoma.